Urinary Retention (Ischuria): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height; further:
    • Inspection (viewing).
      • Skin and mucous membranes
    • Auscultation (listening) of the heart
    • Auscultation of the lungs
    • Inspection and palpation of the abdomen (belly), inguinal region (groin region) (tenderness?, tapping pain?, coughing pain?, guarding pain?, hernial orifices?, kidney bearing tapping pain?) [palpable lower abdominal tumor.]
    • Examination man
      • Inspection and palpation of the genitals (penis and scrotum; assessment of pubescence (pubic hair), penis (penis length: between 7-10 cm when flaccid; presence of: Indurations (tissue hardening), anomalies, phimosis / foreskin constriction?) and testicular position and size (if necessary by orchimeter); if necessary, the painfulness compared to the opposite side or where is the punctum maximum of pain).
      • Digital rectal examination (DRU): examination of the rectum (rectum) and adjacent organs with the finger by palpation (assessment of the prostate in size, shape and consistency, if necessary, detection of indurations (tissue hardening)).
    • Examination woman [due todifferential diagnosis: cervical carcinoma (cervical cancer)]:
      • Inspection
        • Vulva (external, primary female sexual organs).
        • Vagina (vagina)
        • Cervix uteri (cervix), or portio (cervix; transition from the cervix (cervix uteri) to the vagina (vagina)), taking a Pap smear (for early detection of cervical cancer).
      • Palpation (bimanual; palpation with both hands) of the internal genital organs.
        • Cervix uteri (cervix).
        • Uterus (uterus) [Normal: anteflexed/angled anteriorly, normal size, no tenderness].
        • Adnexa (appendages of the uterus, i.e., the ovary (ovary) and uterine tubule (fallopian tube)) [Normal: free]
        • Parametria (pelvic connective tissue in front of the cervix to the urinary bladder and on both sides to the lateral pelvic wall) [Normal: free].
        • Pelvic walls [Normal: free]
        • Douglas space (pocket-like bulge of the peritoneum (abdominal wall) between the rectum (rectum) at the back and the uterus (uterus) at the front) [Normal: clear].
  • Cancer prevention
  • Neurological examination [due todifferential diagnoses: disc prolapse (herniated disc), paralysis of the bladder].
  • Urological examination [due todifferential diagnoses: urinary bladder tumors, unspecified; urethra carcinoma (carcinoma of the urethra, urethral cancer); prostate carcinoma (cancer of the prostate gland, prostate cancer); overflow bladder]
  • Health check

Square brackets [ ] indicate possible pathological (pathological) physical findings.